The Effects of State-Level Medicaid Coverage on Family Wealth

Abstract

cess to key resources necessary for healthy child development. Increased access to Medicaid may affect children both directly, via access to crucial health care, and indirectly by reducing family medical expenses, allowing them to increase their economic resources.Research documents direct positive effects of state-level Medicaid coverage on short and longer-term outcomes for child and adult health (Currie and Gruber 1996;Goodman-Bacon 2018;Miller and Wherry 2019). These effects are quite meaningful not only for children's health, but also for their broader educational progression and human capitalThe Effects of State-Level Medicaid Coverage on Family Wealth m a rgo t jackson , chIn y er e agba I, a nd emIly r auscher Jointly financed by the federal government and the states, Medicaid represents the second largest form of public-sector investment in children. Research documents direct positive effects of Medicaid on children's well-being, but little is known about the effects of Medicaid expansions on the wealth of families with children. Using state variation in Medicaid access during the prenatal and infant period, linked to longitudinal data from the children of National Longitudinal Survey of Youth 79, we ask whether state-level Medicaid generosity is associated with family wealth among families with children and whether these effects vary by parental education and race-ethnicity. We find that greater state-level Medicaid access is associated with a larger total amount held in savings and retirement accounts, as well as in mortgages. These effects are largely driven by non-Hispanic white families, and those with more highly educated mothers.

Wealth Begins at Home: The Housing Benefits of the 1944 GI Bill and the Reproduction of Black-White Inequality in Homeownership and Home Value

“…And yet the HLG increased racial inequality in both homeownership and home value by 1960, largely because of its implementation in an anti-Black economic and social system. These findings contribute to the large literature that demonstrates that seemingly race-neutral policies, when layered atop a "racial structure" (Bonilla-Silva 2015), further exacerbate existing racial inequalities in an array of domains, from housing to wealth accumulation to workplace opportunities (Bledsoe 2019;Connolly 2014;Jackson, Agbai, and Rauscher 2021;Korver-Glenn 2018;Pager, Bonikowski, and Western 2009;Taylor 2019;Wingfield and Chavez 2020). If the large racial wealth gap is to be closed, policy must not only remedy past wrongs, but also inhibit the same mechanisms that reproduced racial inequality in the past from doing so in the present and future.…”

Childhood Wealth Inequality in the United States: Implications for Social Stratification and Well-Being

“…Mechanisms to promote wealth building—homeownership, savings, and stock participation—are characterized by structural and racial inequities that keep them out of the hands of many ( Bandelj and Grigoryeva 2021 , this issue; Conwell and Ye 2021 , this issue). Policies and practices to build wealth among families with children have been scattered and diffuse, and some policies may inadvertently increase wealth inequality rather than reduce it ( Jackson, Agbai, and Rauscher 2021 , this issue; Michelmore and Lopoo 2021 , this issue).…”

“…Depending on our problem definition, policies could be designed to promote multiple goals, including building savings and assets in low-wealth families, or in families of color; reducing “bad debt”; and reducing extreme wealth by individuals and firms. Some evidence is provided in this volume on the value of specific interventions for asset accumulation among low-wealth families, including both asset-building and income-support programs ( Jackson, Agbai, and Rauscher 2021 ; Michelmore and Lopoo 2021 ; Huang et al 2021 ). Notably, interventions to reduce inequality would need to be far more ambitious, targeting both the top and the bottom of the wealth distribution and redistributing wealth systematically and intergenerationally.…”

The long term relationship between childhood Medicaid expansions and severe chronic conditions in adulthood

“…Many analyse how the 1980s-1990s expansions affected shorter term outcomes during childhood (e.g., Currie et al, 2008;Curie & Gruber, 1996a, Curie & Gruber, 1996bJackson et al, 2021;Levine & Schanzenbach, 2009).…”

“…Many analyse how the 1980s‐1990s expansions affected shorter term outcomes during childhood (e.g., Currie et al, 2008; Curie & Gruber, 1996a, Curie & Gruber, 1996b; Jackson et al, 2021; Levine & Schanzenbach, 2009). Others examine the longer term effects of childhood Medicaid eligibility on outcomes later in adulthood (e.g., Levere et al, 2019).…”